Prognosis of Patients With Neuropathic Low Back-Related Leg Pain: An Exploratory Study Using Prospective Data From UK Primary Care

Harrisson, Sarah A.; Ogollah, Reuben; Dunn, Kate M.; Foster, Nadine E.; Konstantinou, Kika

doi:10.1016/j.jpain.2023.09.016

The Journal of Pain

2024

DOI: 10.1016/j.jpain.2023.09.016

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Prognosis of Patients With Neuropathic Low Back-Related Leg Pain: An Exploratory Study Using Prospective Data From UK Primary Care

Sarah A. Harrisson,

Reuben Ogollah,

Kate M. Dunn

et al.

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2024

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Cited by 3 publications

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Predictors of outcome following an epidural steroid injection for disc-related sciatica: a Delphi consensus study

Stynes,

Foster,

O’ Dowd

et al. 2024

Eur Spine J

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Purpose Trial data shows modest reductions in leg pain, disability and surgery avoidance following epidural steroid injections (ESI) for severe sciatica. Despite their common use, there is no clear evidence about which patients are more likely to benefit from ESI. The aim of this study was to generate consensus on potential predictors of outcome following ESI for disc-related sciatica. Methods A list of potential predictors of outcome was generated during a consensus meeting of seven experts. The items were subsequently presented in a two round on-line Delphi study to generate consensus among experts on which items are potential predictors of outcome. Consensus was defined as 70% agreement among participants. Results Sixty-one items were generated during the consensus meeting. Of ninety experts invited to participate in the on-line Delphi study, 44 (48%) and 33 (73%) took part in rounds one and two respectively. Twenty-eight additional items suggested by participants in round one were included in round two. Overall, 14 items reached consensus reflecting domains of health, medication use, pain intensity, psychosocial factors, imaging findings and type of injection. Conclusion Based on expert consensus, items that can be routinely collected in clinical practice were identified as potential predictors of outcomes following ESI.

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Predictors of outcome following an epidural steroid injection for disc-related sciatica: a Delphi consensus study

Stynes,

Foster,

O’ Dowd

et al. 2024

Eur Spine J

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Neuropathic Component Characteristics in Chronic Secondary Musculoskeletal Pain After Postmenopausal Osteoporotic Fractures: A Pilot Cross‐Sectional Study

Pickering,

Perrot,

Christian

et al. 2024

Pain Research and Management

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Background: The neuropathic characteristics of pain occurring after an osteoporosis (OP)‐related fracture are often under‐recognized. The aim of this pilot study is to identify, in patients suffering from pain localized on the site of a previous osteoporotic fracture, the presence of neuropathic characteristics, their medical management, and their impact on quality of life.Methods: This pilot cross‐sectional study on consecutive patients in University Hospital, Rheumatology Department, Clermont‐Ferrand, France, was approved by the Ethics Committee (IRB number 2023‐CF34). Pain was evaluated with the Numeric Pain Rating Scale (NPRS), Neuropathic Component of Chronic pain (NCCP) was screened with the DN4 questionnaire, and sleep was assessed with the Pittsburg questionnaire. Depression, anxiety, quality of life, and concomitant treatment were also evaluated. Results were expressed using effect sizes (ESs) and 95% confidence intervals.Results: Fifty new patients with a history of at least one fully documented fragility vertebral fracture (VF) or nonvertebral fracture (NVF) due to osteoporosis, in the last 2 years minus the previous 6 months, were included. Findings show that 21% patients with VF and 28% patients with NVF reported NCCP (DN ≥ 4). NCCP patients had more intense pain (NPRS = 5.1 ± 2.9 vs. 2.9 ± 2.7, ES = 0.82 [0.18; 1.44], p = 0.019) and impaired sleep compared to patients without NCCP (ES = 0.71 [0.08; 1.33], p = 0.043). A remarkable point was that patients had no specific oral or topical treatment for NCCP and were only taking on demand paracetamol and nonsteroidal anti‐inflammatory drugs.Conclusions: Future research should focus on the neuropathic characteristics of pain patients with OP, in order to better manage OP‐related pain.

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The Possible Association of Burnout and Neuropathic Low Back Pain Among Hungarian Postal Workers: A Cross-Sectional Study

Balajti,

Horvath,

Fejes

et al. 2024

JMDH

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Objective Burnout is an increasingly prevalent phenomenon, which can be associated with a wide range of mental and physical illnesses. There is also a possible connection between burnout and neuropathic low back pain, but the association is poorly studied. Methods The aim of our cross-sectional study was to analyze the prevalence and risk factors of chronic neuropathic low back pain taking many co-variates into account, such as burnout and its main determinants among postal workers. Demographic data, risk factors and concomitant diseases were recorded. Burnout was measured with the Mini Oldenburg Questionnaire (MOLBI), neuropathic low back pain was assessed by the painDETECT questionnaire, insomnia was detected by the Athen’s Insomnia Scale and depression was measured by the Beck Depression Inventory. Results Three hundred sixty-eight males (35.6%) and six hundred sixty-six females (64.4%) participated in our study. Low back pain occured in 182 workers (17.6%), among them 36 workers (19.4%) had neuropathic low back pain, 56 (30.9%) had mixed pain and 90 (49.7%) workers had nociceptive low back pain. In a hierarchical regression analysis strong predictors of neuropathic low back pain included having secondary employment, depression, sleep disturbance and emotional exhaustion (main component of burnout). Conclusion This is among the first studies showing a possible association between burnout and neuropathic low back pain, highlighting the importance of adequate burnout screening and the implementation of interventions to avoid significant disabilities.

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Prognosis of Patients With Neuropathic Low Back-Related Leg Pain: An Exploratory Study Using Prospective Data From UK Primary Care

Cited by 3 publications

References 44 publications

Predictors of outcome following an epidural steroid injection for disc-related sciatica: a Delphi consensus study

Predictors of outcome following an epidural steroid injection for disc-related sciatica: a Delphi consensus study

Neuropathic Component Characteristics in Chronic Secondary Musculoskeletal Pain After Postmenopausal Osteoporotic Fractures: A Pilot Cross‐Sectional Study

The Possible Association of Burnout and Neuropathic Low Back Pain Among Hungarian Postal Workers: A Cross-Sectional Study

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